This research is designed to allow locked-in patients to control a computer. In Phase I, three paralyzed, locked-in patients were implanted with neurotrophic recording electrodes. The current patient, March 24, 1998, continues to perform word processing and produce synthetic speech. For Phase II, the applicants propose to implant long-term neurotrophic electrodes in the voluntary cortex of six cognitively intact locked-in humans. The investigators expect to provide them with control of a computer cursor and aim to separate the individual signals and teach the patient to control different aspects of cursor movement such as speed, accuracy and direction. They also expect to determine if the cortex controlling the signals can be dedicated to cursor control. They aim to develop software to detect signal patterns, implement adaptive controls, improve patient training, automate collection of data, assess alternative communicative methods such as iconic languages, and provide access to the Internet. They will modify and miniaturize the present electronics to provide a single-stage power induction system supplying six electrodes that ought to provide multi-dimensional control. Data from the present patients have demonstrated an alternative means of communication for locked-in patients. Phase III will bring these technologies to many more patients. Current efforts also suggest that movements might be restored to spinal cord injured patients. PROPOSED COMMERCIAL APPLICATION: There are 500,000 "locked-in" patients worldwide, including 30,000 ALS patients in the USA. In addition, there are 250,000 quadriplegics and paraplegics in the USA and 3,750,000 worldwide, many of whom could benefit if the system could be used to control paralyzed muscles. A major aim of Phase III is to determine if the system can assist locked-in patients, and later efforts will be directed towards activating paralyzed muscles. The chairman of Prentke Romich Inc., Mr. Barry Romich, is interested in future commercilization.